The following document outlines a method and system for placing devices enabled for endovascular navigation, and in some embodiments relate to the accurate positioning of peripherally inserted central venous catheters (PICC) and positioning the tip accurately in the optimal location within the superior vena cava (SVC), through the use of electromagnetic tip tracking systems. In general, the method can enable a variety of procedures and internal imaging techniques that rely on electromagnetic position probes being manipulated within the body in reference to surface anatomic markers only. These sorts of hospital based procedures are routinely performed without real time imaging, requiring post procedural radiographic confirmation and possible repeat blind manipulation and re-imaging. Present methods operate through an iterative process of initial device placement, imaging, device manipulation and re-imaging, and eventually a position of the intracranial, intravenous, endotracheal or endoenteric instrument deemed acceptable is achieved. Often, due to the tedious iterative process, suboptimal or non-ideal positioning is deemed acceptable by the medical system. Uncommonly, real time fluoroscopic positioning relative to radiographic landmarks is required to achieve proper positioning. These radiographic landmarks are most often and most reliably related to the bony anatomy which is easily appreciated on physical examination (e.g., the clavicles, sternal notch, xyphoid process, rib cage margins, acromion processes, iliac crests, and symphysis pubis, among other bony surface anatomic landmarks.
It would be advantageous to have a system, such as the present invention, wherein: optimal placement is accurately achieved with image guidance using no x-rays; the placement occurs with creation of a patient specific image representation of the venous anatomy that serves as documentation and is exported to radiology picture archiving communication systems (PACS) in the radiological standard Digital Imaging and Communications in Medicine (DICOM) format; and there can be a high level of hands-on physician (e.g. interventional radiologist) operation during the most critical portions of the placement procedure with high operational efficiencies provided through telecommunication and remote actuation technologies.